Healthcare Provider Details
I. General information
NPI: 1861074031
Provider Name (Legal Business Name): THE POWER OF MHS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/26/2021
Last Update Date: 01/23/2023
Certification Date: 01/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18191 NW 68TH AVE STE 207
HIALEAH FL
33015-3997
US
IV. Provider business mailing address
18191 NW 68TH AVE STE 207
HIALEAH FL
33015-3997
US
V. Phone/Fax
- Phone: 786-236-5772
- Fax:
- Phone: 786-236-5772
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSE
CARLOS
HERRERA
Title or Position: VICE PRESIDENT
Credential:
Phone: 786-236-5772